Point-of-sale marketing and context of marijuana retailers: Assessing reliability and generalizability of the marijuana retail surveillance tool

As recreational marijuana expands, standardized surveillance measures examining the retail environment are critical for informing policy and enforcement. We conducted a reliability and generalizability study using a previously developed tool involving assessment of a sample of 25 randomly selected Seattle recreational marijuana retailers (20 recreational; 5 recreational/medical) in 2017. The tool assessed: 1) contextual/neighborhood features (i.e., facilities nearby); 2) compliance/security (e.g., age-of-sale signage, age verification); and 3) marketing (i.e., promotions, product availability, price). We found that retailers were commonly within two blocks of restaurants (n = 23), grocery stores (n = 17), liquor stores (n = 13), and bars/clubs (n = 11). Additionally, two were within two blocks of schools, and four were within two blocks of parks. Almost all (n = 23) had exterior signage indicating the minimum age requirement, and 23 verified age. Two retailers had exterior ads for marijuana, and 24 had interior ads. Overall, there were 76 interior ads (M = 3.04; SD = 1.84), most commonly for edibles (n = 28). At least one price promotion/discount was recorded in 17 retailers, most commonly in the form of loyalty membership programs (n = 10) or daily/weekly deals (n = 10). One retailer displayed potential health harms/warnings, while three posted some health claim. Products available across product categories were similar; we also noted instances of selling retailer-branded apparel/ paraphernalia (which is prohibited). Lowest price/unit across product categories demonstrated low variability across retailers. This study documented high inter-rater reliability of the surveillance tool (Kappas = 0.73 to 1.00). In conclusion, this tool can be used in future research and practice aimed at examining retailers marketing practices and regulatory compliance. Keywords: Marijuana use, Retail environment, Marketing, Recreational marijuana, Measure developmen

Characterizing the Followers and Tweets of a Marijuana-Focused Twitter Handle

BACKGROUND: Twitter is a popular social media forum for sharing personal experiences, interests, and opinions. An improved understanding of the discourse on Twitter that encourages marijuana use can be helpful for tailoring and targeting online and offline prevention messages. OBJECTIVES: The intent of the study was to assess the content of “tweets” and the demographics of followers of a popular pro-marijuana Twitter handle (@stillblazingtho). METHODS: We assessed the sentiment and content of tweets (sent from May 1 to December 31, 2013), as well as the demographics of consumers that follow a popular pro-marijuana Twitter handle (approximately 1,000,000 followers) using Twitter analytics from Demographics Pro. This analytics company estimates demographic characteristics based on Twitter behavior/usage, relying on multiple data signals from networks, consumption, and language and requires confidence of 95% or above to make an estimate of a single demographic characteristic. RESULTS: A total of 2590 tweets were sent from @stillblazingtho during the 8-month period and 305 (11.78%) replies to another Twitter user were excluded for qualitative analysis. Of the remaining 2285 tweets, 1875 (82.06%) were positive about marijuana, 403 (17.64%) were neutral, and 7 (0.31%) appeared negative about marijuana. Approximately 1101 (58.72%) of the positive marijuana tweets were perceived as jokes or humorous, 340 (18.13%) implied that marijuana helps you to feel good or relax, 294 (15.68%) mentioned routine, frequent, or heavy use, 193 (10.29%) mentioned blunts, marijuana edibles, or paraphernalia (eg, bongs, vaporizers), and 186 (9.92%) mentioned other risky health behaviors (eg, tobacco, alcohol, other drugs, sex). The majority (699,103/959,143; 72.89%) of @stillblazingtho followers were 19 years old or younger. Among people ages 17 to 19 years, @stillblazingtho was in the top 10% of all Twitter handles followed. More followers of @stillblazingtho in the United States were African American (323,107/759,407; 42.55%) or Hispanic (90,732/759,407; 11.95%) than the Twitter median average (African American 22.4%, inter-quartile ratio [IQR] 5.1-62.5%; Hispanic 5.4%, IQR 3.0-10.8%) and among Hispanics, @stillblazingtho was in the top 30% of all Twitter handles followed. CONCLUSIONS: Young people are especially responsive to social media influences and often establish substance use patterns during this phase of development. Our findings underscore the need for surveillance efforts to monitor the pro-marijuana content reaching young people on Twitter

“I just want to be skinny.”: A content analysis of tweets expressing eating disorder symptoms

There is increasing concern about online communities that promote eating disorder (ED) behaviors through messages and/or images that encourage a “thin ideal” (i.e., promotion of thinness as attractive) and harmful weight loss/weight control practices. The purpose of this paper is to assess the content of body image and ED-related content on Twitter and provide a deeper understanding of EDs that may be used for future studies and online-based interventions. Tweets containing ED or body image-related keywords were collected from January 1-January 31, 2015 (N = 28,642). A random sample (n = 3000) was assessed for expressions of behaviors that align with subscales of the Eating Disorder Examination (EDE) 16.0. Demographic characteristics were inferred using a social media analytics company. The comprehensive research that we conducted indicated that 2,584 of the 3,000 tweets were ED-related; 65% expressed a preoccupation with body shape, 13% displayed issues related to food/eating/calories, and 4% expressed placing a high level of importance on body weight. Most tweets were sent by girls (90%) who were ≤19 years old (77%). Our findings stress a need to better understand if and how ED-related content on social media can be used for targeting prevention and intervention messages towards those who are in-need and could potentially benefit from these efforts.</div

A content analysis of vaping advertisements on Twitter, November 2014

INTRODUCTION: Vaping has increased in popularity, and the potential harms and benefits are largely unknown. Vaping-related advertising is expected to grow as the vaping industry grows; people are exposed primarily to vaping advertisements on the Internet, and Twitter is an especially popular social medium among young people. The primary objective of our study was to describe the characteristics of vaping-related advertisements on Twitter. METHODS: We collected data on 403,079 English-language tweets that appeared during November 2014 and contained vaping-related keywords. Using crowdsourcing services, we identified vaping-related advertisements in a random sample of 5,000 tweets. The advertisement tweets were qualitatively coded for popular marketing tactics by our research team. We also inferred the demographic characteristics of followers of 4 Twitter handles that advertised various novel vape products. RESULTS: The random sample of 5,000 vaping-related tweets included 1,156 (23%) advertisement tweets that were further analyzed. Vape pens were advertised in nearly half of the advertisement tweets (47%), followed by e-juice (21%), which commonly mentioned flavors (42%). Coupons or price discounts were frequently observed (32%); only 3% of tweets mentioned vaping as a way to quit smoking or as an alternative to smoking. One handle had a disproportionately high percentage of racial/ethnic minority followers. CONCLUSION: Vaping poses a threat to smoking prevention progress, and it is important for those in tobacco control to understand and counter the tactics used by vaping companies to entice their consumers, especially on social media where young people can easily view the content

Declines in prevalence of adolescent substance use disorders and delinquent behaviors in the USA: A unitary trend?

AbstractBackgroundDownward trends in a number of adolescent risk behaviors including violence, crime, and drug use have been observed in the USA in recent years. It is unknown whether these are separate trends or whether they might relate to a general reduction in propensity to engage in such behaviors. Our objectives were to quantify trends in substance use disorders (SUDs) and delinquent behaviors over the 2003–2014 period and to determine whether they might reflect a single trend in an Externalizing-like trait.MethodsWe analyzed data from 12 to 17 year old participants from the National Survey on Drug Use and Health, a representative survey of the household dwelling population of the USA, across the 2003–2014 period (N = 210 599). Outcomes included past-year prevalence of six categories of substance use disorder and six categories of delinquent behavior.ResultsTrend analysis suggested a net decline of 49% in mean number of SUDs and a 34% decline in delinquent behaviors over the 12-year period. Item Response Theory models were consistent with the interpretation that declines in each set of outcomes could be attributed to changes in mean levels of a latent, Externalizing-like trait.ConclusionsOur findings suggest that declines in SUDs and some delinquent behaviors reflect a single trend related to an Externalizing-like trait. Identifying the factors contributing to this trend may facilitate continued improvement across a spectrum of adolescent risk behaviors.</jats:sec

Risky sexual behaviors and sexually transmitted diseases: a comparison study of cocaine-dependent individuals in treatment versus a community-matched sample

Cocaine users routinely engage in high-risk sexual behaviors that place them at an elevated risk of contracting HIV and other blood-borne infections. The purpose of the present study was to compare trading sex for drugs and/or money, having 10 or more sexual partners in 1 year, and sexually transmitted diseases (STDs) of cocaine-dependent individuals in treatment for their dependence across race and gender and against participants who live in their community. Cocaine-dependent individuals (n = 459) were identified through nine publicly and privately funded inpatient and outpatient chemical dependency treatment centers in the St. Louis area during 2001–2006. Community-based participants (n = 459) were matched to cocaine-dependent participants on age, ethnicity, gender, and zip code of residence. Mean age of the sample was 36 years old, 50% were Caucasians, 50% were African American, and 47% were male. Nearly half of cocaine-dependent participants in treatment had traded sex for drugs and/or money and over one-third had more than 10 sexual partners in 1 year with a risk concentrated among African Americans even after controlling for income and educational attainment. Participants recruited from the community with some exposure to cocaine reported similar rates of high risk sexual behaviors as the cocaine dependent subjects from treatment settings. It is important for clinicians to recognize that once released from treatment, cocaine-dependent individuals may be returning to high-risk environments where sexual risk behaviors are occurring in the context of cocaine use

The utility of Google Trends data to examine interest in cancer screening

OBJECTIVES: We examined the utility of January 2004 to April 2014 Google Trends data from information searches for cancer screenings and preparations as a complement to population screening data, which are traditionally estimated through costly population-level surveys. SETTING: State-level data across the USA. PARTICIPANTS: Persons who searched for terms related to cancer screening using Google, and persons who participated in the Behavioral Risk Factor Surveillance System (BRFSS). PRIMARY AND SECONDARY OUTCOME MEASURES: (1) State-level Google Trends data, providing relative search volume (RSV) data scaled to the highest search proportion per week (RSV100) for search terms over time since 2004 and across different geographical locations. (2) RSV of new screening tests, free/low-cost screening for breast and colorectal cancer, and new preparations for colonoscopy (Prepopik). (3) State-level breast, cervical, colorectal and prostate cancer screening rates. RESULTS: Correlations between Google Trends and BRFSS data ranged from 0.55 for ever having had a colonoscopy to 0.14 for having a Pap smear within the past 3 years. Free/low-cost mammography and colonoscopy showed higher RSV during their respective cancer awareness months. RSV for Miralax remained stable, while interest in Prepopik increased over time. RSV for lung cancer screening, virtual colonoscopy and three-dimensional mammography was low. CONCLUSIONS: Google Trends data provides enormous scientific possibilities, but are not a suitable substitute for, but may complement, traditional data collection and analysis about cancer screening and related interests

Hookah-related Twitter chatter: A content analysis

INTRODUCTION: Hookah smoking is becoming increasingly popular among young adults and is often perceived as less harmful than cigarette use. Prior studies show that it is common for youth and young adults to network about substance use behaviors on social media. Social media messages about hookah could influence its use among young people. We explored normalization or discouragement of hookah smoking, and other common messages about hookah on Twitter. METHODS: From the full stream of tweets posted on Twitter from April 12, 2014, to May 10, 2014 (approximately 14.5 billion tweets), all tweets containing the terms hookah, hooka, shisha, or sheesha were collected (n = 358,523). The hookah tweets from Twitter users (tweeters) with high influence and followers were identified (n = 39,824) and a random sample of 5,000 tweets was taken (13% of tweets with high influence and followers). The sample of tweets was qualitatively coded for normalization (ie, makes hookah smoking seem common and normal or portrays positive experiences with smoking hookah) or discouragement of hookah smoking, and other common themes using crowdsourcing. RESULTS: Approximately 87% of the sample of tweets normalized hookah use, and 7% were against hookah or discouraged its use. Nearly half (46%) of tweets that normalized hookah indicated that the tweeter was smoking hookah or wanted to smoke hookah, and 19% were advertisements/promotions for hookah bars or products. CONCLUSION: Educational campaigns about health harms from hookah use and policy changes regarding smoke-free air laws and tobacco advertising on the Internet may be useful to help offset the influence of pro-hookah messages seen on social media